10. Carcinoma as Related to Age and Sex Among the Florida
Seminole Indians . . . ... .

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INTRODUCTION

Statement of Purpose and Organization

In this study an effort has been made to collect and describe

the conditions to which the Florida Seminole Indian is susceptible, and

thereby form a picture of his health situation; to learn to what extent-

and how-the Florida Seminole's health is affected by his own way of

life as well as by his surrounding physical and cultural environment;

and to watch for any condition or reaction which seems unexplained

through the cultural or environmental influences, but which might be

explained through the effect of any ethnic characteristics of the

Florida Seminole.

The paper is divided into five chapters. The first is arranged

for convenient reference to particular facets of the culture and back-

ground of the Florida Seminole Indian. Thus, ethnographical material

may be found readily for comparison with health and medical data

presented in the following chapters. The second and third chapters

present-narratively and statistically-a resume' of the Seminole

health picture available from 1919 to 1935, and from 1946 to 1949.

The fourth part presents in detail the data available from the exam-

ination of individual hospital and clinical records for the years

196 to 1949, as well as the results of surveys made among the

Seminoles in 1935, 1951, and 1952 by public and private agencies.

Chapter five discusses the medical and ethnographical finding as to

their significance in indicating transition, acculturation, and ethnic

immunity among the Florida Seminole Indians. The conclusions drawn

from this study are found at the end of the discussion.

Lack of sufficient medical description of the Florida Seminole

from "frontier" days makes it difficult to limit the discussion and

references wholly to this group. Data are, therefore, introduced from

other Amerindian areas and groups which might afford insight into, and

possible analogy with the Seminole situation.

1Method Employed in Preparing This Study

1. Preliminary library research was done on data already

available for the Florida Seminole Indian.

2. Personal interviews were held with present and past health

and Indian Agency officials.

3. At the Dania Indian Agency, Dania, Florida, the annual

reports for the years 1919 to 1935 were made available to me for

study. Also at this agency other records and correspondence provided

the basis for a compilation of patient-names and treatment rendered

for the years 1916 to 1948.

4. These patient-treatment lists served as an index for the

study of each of these patient's clinical and admission records at a

1The expression ethnic immunity is used here to mean any degree
of natural or acquired immunity expressed by members of this group, and
which could be characteristic of the whole group.
Racial immunity is a type of natural immunity (Jawetz, et al.,
1956: 109), and perhaps upon further ethnic evidence-and knowled-e in
the field of immunology--the expression ethnic immunity, might yield a
concept'of racial immunity.

large hospital where many Indians were treated. The diagnoses for

Indians treated at other hospitals in the State of Florida were tabu-

lated, but examination of each patient's record was not accomplished.

5. The results of a blood survey made in 1952 was made avail-

able by the Florida State Board of Health.

6. The results of an optical survey made in 1951 were made

available by a Miami optometrist.

7. With the data thus obtained from the above sources, the

collected facts were organized as a guide for further investigation

of facts yet desirable.

8. Library research was done on the health picture of the

Amerindian in general. Medical data dealing with any Amerindians were

reviewed. Data pertinent to the facts already found among the Florida

Seminole were noted, and leads to further investigation among the

Seminoles were noted and used in subsequent interviews and research.

CHAPTER I

BACKGROUND AND GENERAL CULTURE

General

The ethnographic and historical material in this section is

arranged to allow ready reference to the separate topics which the

reader may wish to consult, and to which the writer has referred in

presenting or discussing various health and medical conditions. The

topics include physical environment, history, population data, and

social and economic patterns.

Geographical Environment

The Florida Seminoles are today divided into two main groups.

The Cow Creek Seminole (Muskogean-speaking) occupy generally the

northern part of the Florida peninsula from Lake Okeechobee in south-

ern central Florida north, including the Brighton Reservation north-

west of the lake. The Mikasuki (Hitchiti-speaking) occupy generally

the southern part of the peninsula, including the area around Miami,

the Big Cypress Swamp and some camps along the Tamiami Trail leading

from Miami across the Everglades to the Gulf coast. There are also

commercial camps scattered about which may be inhabited by Indians who

have broken away from any tribal affiliations (Writer's Program 191h: 38).

Among the earliest reports concerning a group of Indians by the

name of Seminoles Bartram (Van Doren 1928: 182) reports in 1773-177h:

The Lower Creeks or Siminoles [sic3 possess a vast territory;
all east Florida and the greatest part of west Florida.

and further:

The country furnishes such a plenty and variety of supplies
for the nourishment of animals, that I can venture to assert,
that no part of the globe so abounds with wild game or creatures
fit for the food of man.

Physical Characteristics

Early reports of travelers in Florida during the 16th century

(Laudonniere), Spanish literature during the 17th century, the 18th

century (Bartram) and the 19th century (IMacCauley) give us much of our

early information on culture and history of the Florida Indians. Due,

however, to the changes introduced by admixture occasioned by the

migrations which contributed to the formation of the present Seminole

Nation, the more recent reports would probably be more suited to supply

time, an anonymous physician reports in 1840 that the Seminoles possess

a greater muscular organization than other Muskogees, and further, that

their constitutional stamina is weak allowing the body to succumb read-

ily to the influence of disease. He reports:

His maladies, general opinion to the contrary notwithstanding,
are perhaps equally complicated with those in civilized life, and
certainly more difficult to manage; whilst the issue of cases
often proves so unexpectedly fatal as to defy all established
rules of prognosis (Anon. 1840: 137-138).

Hrdlicka (1922: 54) states that the full-blood Seminole

impresses one as a "typical, ordinary Indian," reports:

The two seen were slightly deeper than medium brown in color,
with straight black hair and the general characteristics of
the oblong to slightly short-headed type of native. The stature
was moderate to fair, the body and limbs well developed.

For a 20-22-year-old male Seminole he reports a stature of 165 cm.

and a cephalic index of 81.0, with other indices and comments:

All of these measurements and indices, it will be recognized,
are quite common for a southeastern medium developed, young
adult or slightly subadult Indian.

According to Kroeber (1948: 128) a cephalic index of 80 and up in the

skull and 82 and up in the living is brachycranial; this would indicate

the above tends to brachycephaly, thus agreeing with MacCauley's

description in 1881.

Concerning constitution, J. L. Glenn, Special Commissioner to

the Indians (Annual Report: 1932) states:

The members of the Seminole tribe have been endowed with sen-
sually strong, healthful bodies. Their life in the Glades has
accustomed them to hardships. At the same time they lived
without a knowledge of sanitation or an understanding of the
causes of disease. The weak and physically unfit have been
destroyed quickly, and only the strong survived. These condi-
tions have given the Seminole of today remarkable power to recover
from injuries, and many forms of bodily poisonings. A ruptured
appendix is not fatal to a Seminole, or even the poison from the
water moccasin may be successfully disposed of by the body.
Oftentimes he eats food that kill members of the white race.
He suffers from such food but the poison is eliminated without
fatality. The physicians who treat these Indians often remark
that they have a much greater chance of recovery with them than
with white patients. (Italics mine.)

This agrees with the foregoing earlier reports in that the Seminoles

possessed well-developed bodies; the constitutional picture can be

considered a development from the 1840 report inasmuch as Glenn

specified only the strong survived.

History

Beginning about 1695-1715 with the residence of what are called

Oconee Indians in the Oconee River area of Georgia, the literature is

fairly convergent concerning the "ancestors" of the Florida Seminole

Indians. About 1716 the Oconee entered Lower Creek country and settled

temporarily on the east bank of the Chattahoochee River in Georgia

(Swanton 1952: 112) and by 1750 had entered the Alachua plain in north

central Florida.

Swanton (1922: 398) calls this the nucleus of the future

Seminole Nation. From 1773 to 1774 William Bartram made his visit

to the peninsula and applied the name Siminoles to the Muskogee

Indians of Florida. This name was later extended to include the

Hitchiti-speaking people known as the Mikasuki, reported by one

source to be properly Nikasuki or Hog-eaters (Swanton 1922: 401).

During the British Occupation of Florida the Seminoles were friendly

with the British. After the Creek War (1813-1814) many Muskogean-

speaking people (Creeks) from the Upper Creek country entered Florida

where they mixed with the Seminoles and some remnants of aboriginal

Florida Indians--the Timucua and Calusa (England 1957: 147). This

influx of Muskogean-people after the Creek War raised their number so

as to constitute a dominant element in the Florida Indian population

(Swanton 1952: 166). By the beginning of the Seminole Wars in 1817

then, we have a mixture of the Muskogean stock (mostly Creek) with the

Oconee plus mixture with some of the aboriginal inhabitants of Florida.

The attacks on the Seminoles by whites beginning about 1812-1814

ushered in the First Seminole War which lasted from 1817 to 1818.

In 1823 the Treaty of Moultrie Creek was made which limited alloweded")

to the Florida Indians reservation land within the state. However, the

white settlers, in spreading over the state, always seemed to be

frustrated by having to contend with Indians and in 1830 Congress

passed the Indian Removal Act2 to eliminate the obstacles which the

Indian lands were said to present to the expansion of the white settlers

through the Florida wilderness. The Second Seminole War was from 1835 to

1842 and in 1848 a treaty provided that those Seminoles remaining in

Florida should be allowed to possess the Everglades. Further attempts

on the part of the white settlers, the army, and the government to

remove the remainder of the Florida Seminoles to the West followed

from 1849 to 1854. There also followed, understandably, the Third

(and last) Seminole War or Uprising.

Before the last Seminole War there was estimated to be an

Indian population in Florida of two-thirds Creek, one-third Hitchiti-

speaking towns, and several bands of Yuchi (Swanton 1952: 139-140).

2The best figure for true Seminoles prior to 1800 was about
150U Indians minus females; by 1832 the count was about 4500 including
females (Hamlin 1933: 155-177). By 1847 Swanton (1952: 143) quotes the
population left in Florida as 370.

The dress of the Seminole women, the equal of which for intri-
cacy of design cannot be found elsewhere in this country,
consists of a long full skirt made of hundreds of pieces of
bright colored materials sewed together in a manner to make
beautiful designs, and a cape around the shoulders extending
just below the waist. The cape usually is made of a solid
color.

3MacCauley reports in 1881 the use of palmetto and swamp cane
twined baskets and sieves, cypress-wood mortars and pestles, and cypress
dug-out canoes (1887: 517-518). Many of these items are still made
today.

In recent times the men's clothing consisted of a waist-

level "Seminole" blouse or shirt, blue denim pants or blue jeans, and

either tennis shoes, heavy shoes, or army surplus combat boots. Some

of the older Seminoles still wore the three-quarter shirt or dress-

like blouse with sleeves buttoning at the wrist, a long skirt, and

either went barefoot or wore tennis shoes (England 1957: 54). The

blouse and cape arrangement left part of the chest and abdomen exposed

so as to present a bare midriff. More recently, however, this has been

covered by lengthening the cape-at least w-en the women came into

contact with other than their own groups. Children under seven years

of age went naked in camp. Girls of seven to ten years old wore a

petticoat and boys of this age wore only a shirt (Freeman 19hh:

123-128).

In recent times, fewer strings of beads were worn by the

younger women. As an example of former styles, Nash (1931: 7) reports

that one older woman wore many strings of beads--the whole of which

weighed over twenty-five pounds--forming a pyramid from her shoulder

blades to her chin. Silver, as an item of dress, has been abandoned

(Neill 1952: 39).

Transportation.-The last dugout canoe was probably built

several years ago by an older Indian, one of the few remaining who

still know the art (Capron 1956: 829, 823-33). Recent modes of travel

included the airboat ("swamp buggy"), trucks, and automobiles.

Economy

Subsistence.--The Florida Seminole collected and used guavas,

sour oranges, bananas, blueberries, and buds of the cabbage palmetto

plant (Nash 1931: 9). Koontie root4 was an important staple. Hunted

foods included venison, birds of the Everglades (Nash 1931: 10),

oppossum, raccoon, squirrel, and rabbit (Neill 1952: 58). According

to Neill, fishing included garfish, mudfish, eels, catfish, and black

bass. Domesticated animals included swine, chickens (Nash 1931: 10),

and bees (Neill 1952: 29). The Seminoles not only kept horses and

cattle for themselves (England 1957: Sh), but were considered good

horse and cattle grazers by those Florida cattlemen employing the

Indians as range riders (page 15). Agricultural and trade items

listed by Nash (1931: 9-10) were hominy grits made into gruel

(sofkee), coffee, sugar, corn, pumpkins, cowpeas, sweet potatoes,

and sugar cane. Neill (1952: 31) describes garden plots of Irish

potatoes. Interviews with officials at the Seminole Indian Agency

at Dania, Florida and Indian informants in 1957 indicated that besides

such trade items as coffee, sugar, and salt, other items normally

home-grown-such as vegetables, or normally homemade-such as bread,

may from time to time be purchased. The extent of this practice varies

according to the proximity of the Indian camp to stores, among other

factors. Since salt will be considered as a factor in certain con-

ditions (page 68), it might be noted that Nash commented on a

"noticiable absence of salt." This could be due to either a deliberate

1acCauley reports in 1881 the use of Koontie (Coontie) roots.
Koontie is wild cassava, of the genus Manihot (Manioc).

choice in diet or just low provisions at the time according to the

description:

There was a noticeable absence of salt in their dishes, and their
stock of sugar was nearly exhausted (1931: 9).

See footnote for historical reference to salt in the Seminole diet.5

A typical meal was given by Nash (1931: 9) as consisting of a

pot of meat stew, a pan of biscuits fried in grease, and bread (commer-

cial) used as gravy mops. Milk, even for children, was practically

never used (Freeman 19h4: 123). Carbonated soft drinks, commercial

candies, and sweets represented part of the daily diet, as was learned

both by observation of the author and interviews at the Seminole Indian

Agency and camp at Dania.

Tribal Patterns.--The Cow Creeks inhabited mainly the northern

part of Florida and the Mikasuki mainly the southern part (MacCauley

1887: 509). The former were traditionally agricultural people, and the

1957: 66). Incantations, blood-letting, and trances were used therapeu-

tically (Neill 1952: 52).

Basis of Shamanistic Practice, and Theory of Illness.--The

medicine man believed in the central forces of nature, the dual nature

of the soul, and that curative efforts depended upon making the disease

yield to his personal efforts. Disease was associated with dreams and

death in that all three represented various degrees of wandering of one

of the patient's souls (Greenlee 194h: 317). That is, in a dream the

soul returned normally by the end of the dream, in sickness it had to be

coaxed back by the medicine man, and in death it was considered to have

gone too far (west) to be retrieved.

Modern Medicine.--Recourse to the scientifically trained

physician was authorized by the tribal medicine men in 1922 (U.S.

Indian Service Annual Report 1922).

Religion

The Seminole religion centered about a dualistic concept of

two great spirits, the God of Love and the God of Vengeance. The first

was responsible for all that was beautiful and beneficient to man, and

the second was responsible for demons and calamity (WPA 1941: il).

Simple acts of sacrifice were made for the success of the hunt.

If any deer were killed in or near the camp, a small bit of the flesh

was burned before the animal was stewed. (This could be of some totemic

significance).

The "Sin Offering of the Hunt" was made by cremating on the spot

the first deer killed each season. This was believed to secure recovery

for any ailing member of the hunter's family as well as propitiation for

his sins.

The most important religious and legal (page 17) ceremony was

the Green Corn Dance or Busk or Physic Dance. It was a dance of thanks-

giving held when the corn was ripe (page 17), usually in late summer,

and might last three, four, or five days terminating in a feast (WPA

1941: hl). The new corn could not be eaten until the end of the cere-

mony (Fairlie 1928: 69). The drinking of the purgative Black Drink

was an integral part of the ceremony. The three councils (page 17)

held their own Dance in three localities successively so that any

Seminole might attend more than one of the Dances (WVPA 1941: 62).

The Black Drink is an emetic tea made from the leaves of the
cassina shrub which grows in Georgia, South Carolina, and northern
Florida. The leaves are boiled and allowed to ferment before use
according to Cory (1896: 19).

Although the Dance might be omitted several times, it was believed the

Seminole "medicine" would die and all of the Seminoles would perish were

the Dance omitted four successive years (Capron 1956: 834).

Life Cycle

Childbearing and Infancy.--The woman had to remain in the "baby

house" or special hut four days, attended by an Indian midwife or older

clanswoman. Food was especially prepared and served to the woman.

After the four-day seclusion the mother would return to the family

dwelling, but had to prepare and eat her food apart from the family for

the next four months (Peithmann 1956: 90).

The very young were carefully attended by the mother, and to the

older children were delegated the care of the younger siblings no longer

requiring the direct care of the mother (Freeman 19i4: 123).

Education.--The concept that one is stronger than another was

avoided by the mother's not inflicting punishment upon her children, but

leaving disciplinary measures to the tribal community as a whole (WPA

1941: VI). Tribal welfare was of primary consideration (Peithmann

1956: 50), stressing cooperation through non-competition and non-

rivalry (England 1957: 62). Truth and honesty were considered the

highest virtues (Peithmann 1956: 88).

By 1951, Florida Seminole children were attending public schools

and government operated schools (England 1957: 66).

Adulthood.--At the age of twelve years a girl was given a string

of beads, indicating she was then an adult. Also at the age of twelve,

a boy was considered a man (Peithmann 1956: 88).

Among the Big Cypress Seminoles, the older unmarried girls slept

in a separate chickee, as did the older bachelors (Greenlee 1952: 25-31).

Unmarried sons lived with their mother's clansmen (England 1957: 59).

Marriage.--England writes that the general rule was clan exogamy,

and after marriage a matrilocal residence was established. Spoehr's

study of the Cow Creek in 1941 indicated extended matrilocal and matri-

of the Florida Seminole Indian through a description of his ethnography,

including a history of his origin and gradually increasing post-

deportation (after 18h7) population.

CHAPTER II

RESUI L OF THE HEALTH PICTURE: NARRATIVE

General

An attempt is made in this section to show the yearly increase

of health problems, or the awareness of them by administrators and

Indians, for the period 1919 to 193h as covered by the Seminole Indian

Agency Annual Reports (U.S. Indian Service) for those years. First

appearances of conditions will be noted, and official comments concern-

ing the health situation will be quoted where applicable. It should be

noted that the first reported appearance of a condition may be the

first awareness of an already existing one. There are some cases,

however, where a new condition has appeared. In general, the Florida

Seminole shows a susceptibility not only to health hazards concomitant

with his way of life, but also to any infection to which he is exposed.

To 1919

Although the annual records at the Seminole Indian Agency at

Dania cover only the fiscal years 1919 to 1935, and the first reported

case of tuberculosis was on the 1928 list reported cases, Nash (1931:

30) relayed information told to him of three deaths (two male and one

female) about 1902 or 1903 due to tuberculosis.

Nash also reported that the Florida State Board of Health

treated 15 cases of hookworm among the Seminole Indians in 1913.

1920

The report for this year states that although a number of

Seminoles died of Influenza during the last two years, the percentage

was no greater than among white people.

Hookworm was given as the most prevalent condition. Decayed

teeth were also very prevalent. It was found that the upper incisors

were most frequently attacked.

Dr. O. S. Phillips, Special Physician, U.S. Indian Service,

stated in his Health and Sanitary Survey:

The Seminole suffers less from the ravages of disease and
probably enjoys better health than any other tribe of Indians
I have visited.

1921

Besides the reported cases of hookworm, it was believed that

there were many others. Decayed teeth were prevalent, but no typical

"Hutchinson's teeth" observed.

Many of the older Seminoles were reported suffering from

kidney trouble believed to be caused by an unbalanced diet of excess

meat. A program of re-education on proper diet was found to benefit

the older generation.

It seemed to be the first year of contact with the hospital

for the Seminole.

Dr. R. E. L. Newberne, Chief Medical Supervisor, states:

Most healthy tribe in the United States said free from
tuberculosis, but assertion too good to accept without question.
Also said that venereal disease is unknown among them. This I
can accept as a fact.

He concluded that the Seminole health was as good as the white health

in the same climate.
1922

Due to the barefoot habits of the Florida Indian, many younger

Indians had hookworm.

Mention was made of acute kidney trouble with several resultant

deaths in many older Indians.

It was believed that the considerable amount of sickness over

the last year was due to an unbalanced diet of too much meat caused by

a total crop loss.

There wasto be an increase expected in the number of medical

cases because the tribal medicine men had authorized the white

physician's treatment.7

1923

Although there was a gradual increase of sickness believed due

to the crop failure two years ago, it was found that the general health

compared favorably vrith the past two years.

The first reported case of venereal disease among the Florida

Seminoles recorded one case of syphilis.

1924

The general health was reported falling. The most prevalent

Aside from any education or indoctrination of the Seminole by
the whites, is it possible that the medicine men had decided that as
long as the white man was bringing new, unknown conditions into the
hitherto closed cosmos of the Indian, they, the medicine men, would be
authorized by their tribal spirits to borrow alien techniques as
"medicine" against what were alien troubles to the Indianr

conditions were malaria, hookworm and anemia. The high malaria

incidence was believed due to state drainage operations which uncovered

vast areas of muck-lands, thereby an increase in mosquitoes.

1925

No report this year.
1926

A camp for sick and indigent Indians was established at Dania

in Broward County.

Gonorrhea (four cases) appeared for the first time. One case

of syphilis was reported in the white wife of an Indian.

Three cases of alopecia were seen.9

This prevalence of malaria is in contradiction to Greenlee,
(194h: 37) who stated that prior to 1932 no malaria existed among the
Seminoles. He believed that the employment of Georgia Negroes in
Everglades' sawmills was responsible for the introduction of malaria
among the Florida Seminole. Nash (1931: 20) reported:

Dr. Claxton (who made a survey in 1930 for the Florida State
Board of Health) points out that malaria exists at Okeechobee
and Keenansville, and that wherever there is a sawmill employing
colored hands there is almost certain to be a focus of infection.

This would seem to indicate that although the sawmills can be impli-
cated due to substantiation by both Greenlee and Claxton, Greenlee's
figures might be somewhat late to account for the many cases of
malaria in 192h.
9
Holder (1882: 42) in reporting conditions from among the
Crow Indians stated:

Bald heads are unknown, even though syphilis with attendant
alopecia prevails.

This alopecia among the Seminoles corresponds chronologically to the
appearance of venereal infection among them during the past several
years.

1927

Aside from noting that anemia, malaria and influenza led the

list, it was stated that due to the effects of the September 18, 1926,
10
hurricane the annual report's correctness was impossible.
1928

The general health was reported not good due to adverse weather

and influenza epidemic among the Big Cypress in December 192-7. -There

was one death. The first smallpox case was reported and the first

official tuberculosis case was reported.
1929

There were two epidemics of "Spanish" influenza during the last

year; prompt hospitalization resulted in only one death.

The general health was believed to be gradually weakening due

to the excess use of poison intoxicants.

It was pointed out that due to the excess use of poor grade

intoxicants during pregnancy by expectant mothers, arrested mental and

physical development was being shown in babies born at this time.

Infant mortality had been reduced to the level of the white

population due to the Indian's acceptance of the white physician

at childbirth.

It was realized that (postulated that) many of the diseases

among the Seminoles were due to the bad dental condition in practically

all of the Indians.

1One of Florida's worst storms. The highest velocity, sustained
for five minutes, was 123 mph, with the maximum velocity reaching 132 mph.
There was 75 lbs./sq. ft. wind pressure. This full hurricane caused
$75,000,000 damage.

1930

There were 14 reported cases of gonorrhea. Appropriations

were recommended to combat this disease "before it gets too great a

start among these people."

Nash (1931: 17) quoted Dr. Claxton's findings in 1930 as:

Everyone has pyorrhea, even children around 8 years of age.
The women-after 20 years of age begin to lose their teeth;
in fact, beginning decay was marked at 10 and 12 years. The
teeth gradually rot off and the roots are eventually pulled
out. Toothache is common. The fact that these people never
drink milk or eat green vegetables would account for the
early tooth decay. Toothbrushes are entirely unknown.

seen in the excess use of alcohol, venereal disease, and the intestinal

disorders 11

lIt may be of interest to note that Von Martius, reporting
upon the Brazilian Indians in 1844, attributed the causes for the
greatest ills among the Indians to smallpox, measles, syphilis, and
the abuse of alcohol (aguardente).

J. L. Glenn, Special Commissioner to the Indians, reported:

Through their increased contact with the white people in recent
years, the Seminole is meeting disease.conditions against which
he has no great resistance. The two largest dangers threaten-
ing his health are ills growing out of intemperance in the use
of alcohol and the venereal diseases.

He gave intestinal disorders the third place. This included hookworm,

dysentery caused by unsanitary foods, and serious constipation caused

in many cases, he believed, by lack ofa balanced diet. The Seminole

children did not drink milk-and suffered from malnutrition.

The prevalence of rheumatism, previously as well as this year,

was thought due to exposure to the wet condition of the Everglades.

1933

The first case of a gonorrheal infection of the eye of an

Indian child was reported.
1934

It was stated that the death rate was slightly less than double

that of the white population. It was also noted that approximately

one-third of the Indian population "suffered some form of throat or

lung disease."

There were 62 cases of measles and 26 cases of whooping cough

treated in 1934.12

12
Holder (1892: 42) reports from among the western Indians:

Epidemics of whooping cough have usually followed measles, as in
white communities, and have been more fatal in about the same
degree as measles.

and further:

This disease, so trivial under favorable hygienic conditions
among whites, finds in the Indian a most vulnerable pulmonary

Summary of the Narrative Health Picture

The reports for the period 1919 to 1934 seem to indicate

almost a yearly progressive deterioration of Seminole health. Although

year of contact of the Florida Seminole with hospital care, and in 1922

the tribal medicine men authorized white physicians and their treatment.

It would then take several years before the real status quo of the

"hinterland" could become apparent, since according to a comment in

the 1921 population figures, the total 452 Seminoles recorded that

year "are scattered over 9,000 square miles with practically no white

population nor roads." (U.S. Indian Service, 192L)

The diseases and conditions given as chronic ailments, or

reported consistently enough to be considered concomitant with the

Seminole mode of living, included hookworm, anemia, malaria, oral

infections and decayed teeth, rheumatism, and intestinal disorders.

system, and meeting little resistance there, by disabling that
leg or the vital tripod causes many deaths. (Italics mine.)

The 1924 Annual Reports stated that the Indian was kept free
from the state-wide measles epidemic; many cases.of measles were
reported among the Indians, however, during the second outbreak in
1934. There seemed to be an increase of pulmonary and respiratory
infections among the Indians concomitant with the second measles
outbreak. Whooping cough entered the area (community) after the first
measles epidemic, and simultaneously with the second. Thus, we might
find some agreement of the Seminole situation with Holder's findings.

34

The influenza epidemics following the First World War had

their toll among the Florida Seminoles as well as among other groups.

The Seminoles also suffered a measles epidemic in 1934.

Based upon this resume, it seems that the Florida Seminole

was susceptible to any health hazard to which he was esposed.

CHAPTER III

RESUME OF THE HEALTH PICTURE: STATISTICAL

General

The following figures in Table 5 were taken from the Seminole

Indian Agency Annual Reports (U.S. Indian Service) for the years 1920

to 1935, and compiled from hospital records for the years 1966 to 1949.

Although the figures found may have been statistically unreliable in

some instances, it should be noted that these figures may be useful in

qualitatively recognizing the Seminole's susceptibility to various

diseases and conditions.

TABLE 5

NUMBER OF CASES OF REPORTED CONDITIONS FOR
THE FISCAL YEARS 1920 to 1935*, 1946 to 1949**

number of pregnancies previous to, and including the one for which the

patient was admitted to the hospital during the period covered by this

study:

Number of times pregnant

Number of cases
7
2

1
5

Unknown

Age of Seminole Women in Hospital Delivery.--Table 6 shows the

age of the same group of twenty-four women, their previous pregnancies

(gravida), the number of live births (para) up to this pregnancy, and

the condition of the newborn from this pregnancy.

1Comfort, after Parker (1891: 330), believed the age at menarche
is modified by climate, tribal habit, etc., and stated that the white
girls at frontier military3 posts menstruate at an early age. Monte-
zuma, after Parker (1891: 330) found that Indian girls menstruate about
one year earlier than white girls; he made his observations among the
Apache of Arizona. Era, after Parker (1891: 330), found the average
age at menstruation among Indian girls to be lh years; his observations
were in Nebraska.

TABLE
AGE AT DELIVERY I.CLiD.-:G
AIND CONDITION OF

Age
16
16
18
18
19
21
22
23
24
2h
26
27
28
28
29
30
35
35
35

40
16-19-20
Unknown

Gravida
1
1
1
1
1
2
6
3

4
-

2
5
3
6
4
2

7
1
3

6
PREVIOUS .r c;Al.CIES
THE iiZ.'jEO.R:!;.-

Para
0
0
0
0

0
5
2

3
1
4
2
5
1
1

6

2

Newborn
Good
Good
Unknown
Good
Unknown
Good
Good
Good
Good
Good
Unknown
Good
Good
Unknown
Unknown
Good
-Good
Good
Septic

Fair
Good
Good

abortion at
4 months

*Data from case histories for the years 19h5-1949, at Jackson
Memorial Hospital, Miami, Florida. Although there seems to be among the
Seminoles an interim of several years between menarche of the mother and
the birth of her children, it should be borne in mind that the age
quoted by Seminole patients or their kin is subject to doubt as to
accuracy in some cases.

Duration of Labor.-Table 7 is a description of the duration of

labor with delivery at term (except for one case reported as "O0 weeks"

and two not reported, but probably also at term) compared with the type

*Data from case histories for the years 19h5-19h9 at Jackson
Memorial Hospital, Miami, Florida. In eight cases of term delivery
(spontaneous and low forceps) the duration of any of the stages was
unknown. The two abortions have also been omitted from the above
tabulation.

Ease of Delivery.--The following data describe the types of

delivery, and the number of cases of each:

Type of delivery

Cases

Spontaneous
Low forceps
Abortion
Unknown

*Excluding one complete abortion;
the foetus was expelled before
admission to the hospital.

were reported. The two female cases were possibly from the same family.

One monster was reported in 19h7. It was a male with a double

hair-lip, cleft palate, imperforate anus, and no apparent eye-balls.

Venereal Disease.--As to the freedom from venereal disease

among the Seminoles, and conversely the complication of labor due to

it, the following data are reported: of the same group of twenty-four

Seminole women, only two had positive Kahn results (plus 1 and plus h),

16-
1It might be reasoned that many of the twenty-four cases were
foreseen as potential complications while still in the Seminole camp,
and were sent to receive white medical assistance. In such a case as
that, these hospital deliveries might represent a small segment of the
total birth picture. On the other hand, if the majority of these cases
were located on the reservation grounds or commercial camps near the
-city, they would have probably been brought into the hospital as
routine. To determine whether the maternity cases were representative
cf the former or the latter situation would involve detailed investi-
gation as the Seminole changes residence at intervals and there is more
or less continual interchange of backwoods Indians with those living in
proximity with medical facilities.

giving birth to normal, well babies. Of reported prenatal cases of

pregnancy with syphilis only one 32-year old female, 6- to 7 months

pregnant, was recorded. No data concerning the outcome of her

pregnancy was available.

Eclampsia and Toxemia.--One case of eclampsia was noted in a

29-year old pregnant Seminole female admitted to the hospital in August

Cerebral hemorrhage with right hemoplegia and partial loss of vision and

azotemic coma.

In 1934 six cases of toxemia were reported among the Seminole

Indians.

See page 68 for discussion of role of diet in eclampsia and

toxemia.

Post-Partum Hemmorrhage.--Information concerning post-partum

blood loss in the clinical records and delivery notes was deficient.

The few notes which were made on blood loss reported several estimated

and measured volumes of about 30 cc., 50 cc., and 300 cc. The failure

to record the loss could indicate that the quantity was negligible or

normal (whatever that was in that hospital at that time).

Post-Partum Care.--Dr. Claxton (Nash 1931: 34) proposed from

his survey in 1930:

S. that many gynecological examinations would reveal many
prolapsed uteri and other abnormalities due to improper
exercises directly after childbirth.

As concerns this post-partum care, several Seminole informants which the

writer queried in 1957 reported that the Seminole woman used no device

similar to the "squaw belt" (corset-like strip used by the Plains

Indians to compress the abdomen sometimes before, and more usually

after, childbirth), but does make use of a special diet and resorts

to some special exercises after being delivered.

Indeed, there were accumulated several various female disorders

and conditions among the Seminole women as per Dr. Claxton's prediction.

See Table 7, page 53.

Psychological Response to Maternity Hospitalization.--The

following situations concern the Seminole woman and her relation to

hospitalization

1. Miss Conrad5 reports this incident concerning a maternity

case in what she called a "real tribal family" (that is, living accord-

ing to the tribal law). The Chief of the woman's tribe said "she not

want him burned," referring to the reason behind why the woman did not

want to go to the hospital for delivery; she was afraid the placenta

would be burned (incinerated). So it was arranged for the delivering

physician to have the placenta wrapped up and returned to the family.

Thereafter, MissConrad received no further requests for the retrieved

placentas of women delivered in hospital now that the Seminoles knew

that it could be had if wanted.

2. Several of the histories of maternity cases had attached

forms (a Release from Responsibility Discharge) stating that the father

Miss Charlotte Conrad, former U.S. Public Health Nurse,
worked among, and is familiar with Amerindians, especially the Seminole
Indians- of Florida.

demanded release of his daughter before the attending physician

thought it advisable.

3. One maternity case had the comment in her record that she

refused to talk or answer questions placed by the staff.6

h. One mother would not remain in the hospital for treatment

because her children would not be allowed to remain with her.

5. In some cases a "feeding problem" of the child was what

prompted the mother to bring the child to the hospital. This was

entered in the admission notes, but other diagnoses were usually made.

---.. .- Visual ahd Ocular

The following data concerning eye inflammations were compiled

from a 1935 survey made in the Miami-Dania-Everglades, Florida area

(U.S. Indian Service 1935):

Cases of eye inflammation Age-sex of cases
1 Females under 6 years
9 Females over I. years
9 Males over 15 years
3 Females 6 to 15 years
2 Males 6 to 15 years

There were twenty-four Cases of eye inflammation among forty-nine
17
Seminole Indians.17

According to the author's own observations, some women, who
would be terror-stricken to deliver alone at home, relax, are reasonable
and of good cheer when confident of surrounding aid in a hospital. The
reserved Seminole Indian woman--reported at one time to have gone into
seclusion in the bush and have severed with her teeth the umbilical
cord--might understandably become rigid with apprehension, lost among
the gleaming and glistening paraphernalia of modern obstetrics.
17
1For the same area the survey reported seven cases of eye
inflammations among forty-one whites, and five cases among seventeen
Negroes.

The following data from the same survey report the cases of

ptergyiums occurring within the same group:

Cases of ptergyiums Age-sex of cases
h Females over 15 years
6 Males over 15 years
-ii p
There were ten cases of ptergyiums among forty-nine Seminole Indians.8

In 1951 Friedman (1952: 7) surveyed thirty-two Seminole Indian

children at the Dania Reservation at Dania, Florida. All but three

attended local public schools and did very little close eye work at

home. The ages were six to fifteen years old with one pre-school

five-year old. The five-year old had a left esotropia due to con-

genital blindness from cataractous lens; the child's father had a

similar condition. Friedman concludes:

Of thirty-two Seminole Indian children given static retinoscopy,
one simple myope, one simple myopic castigmat and two emmetropes
were found. The latter can be considered as verging on myopia.
Since natives usually show little incidence of myopia these few
would indicate a possible myopia induced by environmental stress.
(Italics mine.)

He states that the distribution of Seminole cases (74 per cent with

.50 to plus 1.00) "seems similar to findings among other U.S. school

children."

Circulatory

Table 8 represents data collected in 1935 concerning Seminole

Indian blood pressure and pulse rates.

18For the same area the survey reported two cases of ptergyiums
among fifteen whites, and two cases among seventeen Negroes.

--Data from the Annual Reports of the Seminole Indian
Agency, U.S. Indian Service, 1920-1935, and data from case
histories for the years 19h5-19h9, at Jackson Memorial
Hospital, iiami, Florida.

This can hardly be considered more than just qualitative evidence that

the Seminole Indian is susceptible to carcinoma.

Epilepsy

Miss Conrad states that she had personally observed an epileptic

seizure in a full-blooded Seminole Indian male. This was prior to 1946.

Albuminuria

The examination of the individual case histories revealed many

patients with albumin in the urine; the albumin ranged from a f aint

trace to plus four. The albumin was present not only among acute and

chronic cases of disease, but also among accident and injury patients.

This might be indicative of dietary conditions or metabolic processes.

Blood Sugar

According to the Florida State Board of Health 1952 Survey, their

were found to be nine cases of excess blood sugar among 279 Florida

Seminole Indians tested.

e

Hemoglobin Content

In 1952 the Florida State Board of Health made a blood survey

among the Florida Seminole Indians and the results show a peak of

hemoglobin content of 13.0 to 13.8 grams/100 cc. among 13U Indians.

If a value of 14-15 grams/lOu cc. for both sexes is considered normal

for Americans (Merck Index 195h: 1659), the Seminole falls under this

value. The reader is reminded of the heavy hookworm infestation among

these Indians and the many cases of anemia, and is referred to Table 5

on page 36.

Syphilis
According to the above 1952 survey, there were found among

279 Seminole Indians tested to be three positive laboratory diagnoses

of syphilis and eleven doubtful cases. See page 5h for other data.

Possible "mongolian spot"

An eight-month old Seminole female Indian was admitted to the

hospital for an upper respiratory condition; the admission notes

contained a comment on a "large, soft, purple-looking spot over the

coccygeal area."

Psychological Response to Illness and Hospitalization

The following has been quoted from J. L. Glenn's comments in

the 1931 Annual Report of the Florida Seminole Agency:

Hospitalization in all probability hastens death, for the Indians
have always lived under an open sky.

To place a man whose posterity for thousands of years lived in the
open in a closed room would induce lung trouble. To place such a
man while sick in such a condition, in all probability would
hasten death.

* . . . . . . .
An infirmary suited to the needs of the Seminole must not conflict
with those age long racial habits of the tribe. A patient, to
make progress, must be contented and happy. As long as the six
walls of a closed room lock a Seminole from the open sky, the
sunshine, and his kinsmen and people, he will never be happy. All
hospitalization ought to be done on the reservation and should be
adapted to the needs of this people.19

And .in 1935 Glenn writes:

When confronted with disease the Seminoles are beset with many
fears-fears that the white man has long left behind. A hospital
room may be crowded with the ghosts who have died in it--ghosts
who, all through the night, reach their long and white arms down
from the ceiling toward the suffering Indian. To warn them of
the dangers of any serious disease often drives them back to
their own medicine man and away from aid. Some aged relative
may get a notion that there is no aid for an afflicted relative
of the tribe. Strangely enough the patient refuses the services
of the physician, and awaits the "big sleep."

In some cases the Indian has enough vitality to recover and live
to discredit the prophecy of his relative. Their health problems
will be met through patience, tact, and education.

Miss Conrad has observed that the Seminoles cannot see the use

of being examined if they feel that they are not ill.

Summary of Individual Topics

The female functions of menstruation and birth were described

from available sources. The menarche falls within the reported range

for North American Indian woman, but toward the lower end. The

description of the psychological response of the Seminole Indian woman

to hospitalization may indicate how to improve hospital care for this

group. Parker (1891: 330) wrote the following of western Indians, but

19
19Bercovici writes of the Gypsies: "Whenever Gypsies have
settled in homes, their per cent of consumption is far greater than that
of the native population." (The Story of the Gypsies, N.Y., 1928)

which could also indicate the Seminole situation as per the available

data in this study:

The daughters and granddaughters of those sturdy aboriginal
matrons consult the pale-face doctor and are rapidly acquir-
ing the methods of the pale-face woman. We can do little to
prevent this evolution. One great stumbling block toward
success in this direction is the present physical condition
of the Indians. (Italics mine)

The naturally robust constitution is deteriorating and mis-
carriages and diseases peculiar to women are noticeably
increasing to the surprise and disgust of the Indian mothers
and grandmothers. The changes made are too radical--certainly
they are not rational--and the inevitable result is just what
might be expected--very general failure. (Italics mine.)

Findings of eye inflammations, ptergyiums, and possible myopia

due to "environmental stress" (Friedman 1952: 7) were the result of

three surveys, 1935, 1951, and 1952.

A representation of various cardiac conditions found among

the Seminoles was given. The blood pressure and pulse values reported

for some of the Seminoles were higher than those reported for Indian

groups in Peru, Central America, and parts of North America (Wilson

1950: 99); they were slightly lower than the white and Negro values

from the same area where the Seminole, white, and Negro groups were

tested together.

Carcinoma was found related, as far as was known, to an

advanced age in the patient.

The detrimental effect of hospitalization upon the Seminole

Indian, both psychologically and physically (especially in conjunction

with tuberculosis) was considered.

CHAPTER V

DISCUSSION AND CONCLUSION

General

The discussion is organized into short considerations of the

Seminole way of life, acculturation, environment, ethnic immunity, and

possible transition phenomena, each illustrated with ethnographical

or medical material. A general conclusion of the whole study ends

the discussion.

The Seminole Way of Life

Let us see if the presence of any condition can be attributed

to a pattern in the Seminole mode of living. A good illustration should

be a condition which is not only reported frequently in the annual

reports, but is shown in "cover-all" surveys which do not depend so

highly upon the Indian's reporting for care of his own free will. This

latter type of patient may present just the serious or advanced form of

a condition, the milder forms being accepted by the Indians as normal

. for their way of life. Therefore, those conditions which have

been studied by survey methods may give a better insight into that

"way of life" or group pattern which is not always at first evident.

The illustration given here--conjunctivitis--was chosen because

of the steady indications of it through the source material--the annual

reports, hospital records, and surveys. It is in the surveys and

hospital case histories that there is most evidence of widespread

conjunctivitis. Although eye inflammation, or conjunctivitis, does

not appear in the annual reported lists of conditions more than

several times annually (see Table 5, page 36), I believe this is due

to the fact that the Seminole does not bother to report this condition

(or did not) unless he is definitely losing his tolerance of such minor

irritations which seem to be concomitant to outdoor living.20 In his

1951 report, Friedman reported that many children had conjunctivitis

(see page 58), and I have seen the admission notes on hospitalized

Indian children where examining physicians remarked on its general

presence in the children. In the examination given to forty-two

Seminoles as part of the 1935 survey (see page 57), over fifty per cent

were found to have eye inflammations, and of these the majority of cases

were males and females over fifteen years old.

Smoke as Factor in Conjunctivitis.--Is it possible that constant

irritation by the pungent smoke and many particles of wood fires contrib-

utes to eye inflammation among people employing such fires daily? In

blaming conjunctivitis upon smoke and face-paint, Holder (1882: 329)

refers to the Siouan name of the month of October--"sore-eye-month"--

to illustrate the incidence of this condition among the Sioux Indians.

(With the beginning of colder weather at this time, the Sioux probably

came into more contact with indoor fires and smoke).

Let us see what contact the Seminole has with smoky fires. The

Florida Seminole does not now cook in a closed dwelling, but in a

special chickee just for that purpose. (Before the widespread use of

the chickee following the Seminole Wars, a closed dwelling type was

described by Bartram (Van Doren 1928: 168) in 1773-177h, in which a cook-

room was located).21

If it could be assumed that most of the Seminoles still lived

most of the time in their chickees during the periods covered by the

health reports, we could perhaps expect some difference in eye inflam-

mation rates between males and females due to the women's prolonged

contact with the cooking fire in the cook-chickee. Of twenty-four

cases of inflammation among forty-two Seminoles, thirteen were females

and eleven were males. This is, of course, a meagre sample. However,

it might be noted that there is practically no difference. This might

indicate two possibilities: the Seminole male spends as much time at

the hearth as the women in his family, or there is another contact with

fire and smoke which affects both male and female equally. To consider

the first possibility, it must be noted that the Florida Seminole male

21Bartram's description of an enclosed cook-room in early
Florida architecture leads one to question Wissler's belief that the
absence of smoke-holes in most of the southern North American Indian
architecture indicated that in the whole area cooking was probably
carried on outside of the dwelling (Wissler 1922: 110). For another
possible reason for the absence of smoke holes, see footnote 22, page 67.

of more recent times did not always trek off daily on the hunting

trail as did his ancestors, but remained at the hearth engaged in

handicraft, the food coming from the general store with the excep-

tion of several home-grown and collected items. And to consider the

second possibility, we learn that those males occupied in work away

from home would probably still be exposed to smoke; the Seminoles used

a fire not only for cooking, and comfort during wet and cool weather,

but also as a protection from the Everglades mosquitos this latter

making especial use of smoke and smouldering fires.22

Vitamin Deficiency as a Factor in Conjunctivitis.--Insofar as

the role of vitamin deficiency in conjunctivitis is concerned, there

might be some objection to saying that the Seminole children suffered

from malnutrition, even before many had begun public and government

schools; although by certain modern American standards, children living

in an aboriginal state might be classed as undernourished, those child-

ren surviving into adulthood have been known to become well-formed,

strong, active adults-albeit sometimes of the "lean and hungry" warrior

type. Those factors, however, which might indicate malnutrition, and

which were found among the Seminoles included heavy parasite infestation,

and the lack of certain foods in the diet-namely milk.

22Swanton (1952: 427) quotes Dumont de Montigny as suggesting
that the omission of smoke-holes among the Caddo Indians was to rid the
dwelling of mosquitos. Dumont's observations were published in 1753.

Acculturation

Arthritis.--The first reported case of arthritis (1929) among

the Florida Seminoles corresponds with the first mention of the use of

alcohol to excess among them, Von iartius (1939: 92) reported in 1884

from Brazil:

Arthritis, recognized one of the principle ills of the red race
in North America, is of rare occurrence here [Brazil) and was
almost completely unknown before the widespread use of alcohol
[aguardente.].

It is not certain from the records whether the arthritis found a;ong

the Seminoles was the same as that type most likely to be associated

with alcoholic and dietary indescretion, i.e., gout, etc.

Toxemia and Eclampsia.--According to a Seminole informant, the

Florida Seminole woman, in addition to seclusion at the time of her

confinement, is restricted in her diet. The informant believed the

intake of salt--having increased with contact of the Indian with the

white population--had "something to do with some of the Seminoles

becoming sick."

Rothstock (1939: 750), in writing of western Indians,23 says:

Toxemia and eclampsia appear to have been unknown among the
Indians in their primitive state and it is probable that their
mode of life and restricted diet were important factors con-
tributing to their immunity. (-Italics mine.)

2Another reference is made to restricted diet by Rothstock
(1939: 750) writing on western Indians:

Her strenuous life, her frugal diet which at times amounted to
restriction bordering on starvation, regulated and restricted
the growth of the fetus to limitss which insured an easy passage
through the bony pelvis. Post maturity with overgrown babies
was unknown. (Italics mine.)

and further:

From the foregoing we may fairly assume that the Indian woman
lived on wholly what was the equivalent of a salt-free diet,
and if the opinion of Desnoo is correct, that on a salt-free diet
a woman never develops toxemia or eclampsia, might this custom
explain their immunity from toxemia? (Italics mine.)

Ethnic Immunity Versus Yfay of Life

There were not many cases of tumors or carcinoma reported

among the Florida Seminole Indians; those reported with an age, give

an advanced one. If these cases that were reported represent all or

most of this condition among all or most of the older Indians, then

the facts found among the Seminole may agree with the following con-

clusions of Hrdlicka and Rothstock concerning Amerindians in general:

Hrdlicka, after Levin (1919: h22-h35), wrote:

The relative excess of aged persons (80 years and above)
among the Indians can signify only that the infirmities
and diseases known ordinarily as those of old age are less
grave among them--a conclusion in harmony with general
observation. (Italics mine.)

and further:

Thus the difference in age cannot account for the rare
occurrence of cancer among Indians.

Rothstock (1939: 750) states in 1939:

Exhaustive studies have been made of the susceptibility of the
Indian to malignant disease, and, while the results have at
times been conflicting, practically all agree that among the
Indians living in present-day conditions cancer is less common than
in whites. There is reason to believe that it was much less
common among primitive Indians as in most instances they died
before the cancer age, the average being thirty-five or forty
years. (Italics mine.)

The above might possibly be interpreted a result of ethnic

immunity or of some as yet undefined facet of the Indian way of life.

Ethnic Immunity Versus Environment

Tuberculosis as Related to Ethnic Composition and Environment.--

Among the Florida Seminoles there were eleven reported cases of tubercu-

losis, three alluded to in years preceding the 1919-1935 annual reports,

and two questionable cases; in all there were fourteen plus the two

questionable cases.

Compared with Oklahoma Seminole rates, the Oklahoma "pure"--

which Hamlin (1933: 160) compares with the Florida Seminole-show a

higher rate of tuberculosis than do the Oklahoma n"mixed."

Hamlin reports:

The only diseases which show significant difference in
incidence between the "pure" and the "mixed" groups
are malaria and tuberculosis.

The Oklahoma "mixed" Seminoles show 14.3 per cent malaria and

1.7 per cent tuberculosis; the Oklahoma "pure" Seminoles show 3.7 per

cent malaria and 1l.6 per cent tuberculosis. These facts could indicate

the following: (1) The full-blooded status of the Florida Seminole

could be questioned; however, the population figures on page 8 report

a very low admixture; (2) The effect of environment, i.e., the presence

of infection among the neighbors of the Oklahoma Seminole (or if not

human carriers, then some other vehicle); (3) The Florida Seminole

presents a special case.

In regard to this latter case, and the possibility that the

pure-blood Florida Seminole is less susceptible to tuberculosis than

the pure-blood Oklahoma Seminole, Krogman (193h: h27) finds that the

Oklahoma Seminole--albeit "pure"--is pure Indian at the most, and not

pure Seminole as the Florida group is believed to be.24 This "racial

or ethnic integrity" was maintained, at least until recently, by

marriage restrictions2 and by geographical and physical isolation.

Hamlin (1933: 177) states:

The low frequency of tuberculosis among the Florida Seminoles
even today emphasizes the importance of isolation along with
preservation of native habitus in resistance to (or perhaps
avoidance of) any new etiological agent.

Thus, if any ethnic traits are operating, the environmental factor

masks it--at least as far as this study shows. Up to the present

(as covered by these data) the Florida Seminoles have shown the above

conditions in great profusion, but without apparent predisposition

thereafter to tuberculosis.

Again we have the possibility of ethnic immunity. The break-

down of the isolation factor (page 25) might be expected to yield

information on these ethnic traits, if present. However, the break-

do wn of the isolation might be accompanied by a possible change in

those traits as well as a modern medical and sanitary science to combat

rampant manifestation of tuberculosis.

On the other hand, assuming the isolation factor to be the most

important at this time as based on the foregoing sections, perhaps with

24
2Krogman (1934: 427) states: "The Oklahoma Seminole is an
extremely mixed type; non-Muskhogean (Hitchiti) plus Muskhogean (Creek),
white, Negro. These are his essential ingredients. Add to their inter-
mixture with other Indians and the crossing.and re-crossing of all the
variants, and the "full-blooded" becomes at best a full-blooded Indian
rather than a full-blooded Seminole."

to assume a greater significance in regard to that disease--in spite of

modern medical and sanitary science--and its possible future increase

among the Florida Indians.

Further Infection Through Acculturation, or
Protective Action Through Ethnic Immunity

Trachoma.--In the case of tuberculosis and hookworm, one was

prevalent in Oklahoma, but not in Florida (tuberculosis), and the other

was absent in Oklahoma but rampant in Florida (hookworm).26 The inci-

dence of trachoma, however, did not exceed three cases in Oklahoma in

1932, nor has more than one possible case been reported in Florida.27

The Florida Seminoles do show a high incidence of conjunctivitis

(Table 5, page 36). Related viruses are responsible for both trachoma

(or granular conjunctivitis) and the non-cicatricial conjunctivitis

known as inclusion blennorrhea or swimming pool conjunctivitis (Jawetz,

et al. 1956: 331). Could this incidence of conjunctivitis indicate a

precursor or "catching up" of the Florida Seminole to one of the scourges

of the Amerindian--trachoma? Or--if it can be shown the Florida

26Hamlin (1933: 155) reported in 1932 not a single case of hook-
worm among the Oklahoma Seminoles. Compare this with the Florida sit-
uation which prompted Claxton to comment in 1930 that many Indian child-
ren were so infested with hookwvorm that they showed valvular leaks
(page 36).
27
In the 19h6-1947 annual report there wasreported one case of
granular conjunctivitis (Table 5, page 36).

Seminole Indian has already "caught up" as much as he is going to do--

could this hitherto freedom from trachoma indicate the presence of any

protective action of any ethnic immunity in this Indian group?

Bacteriological investigation is indicated as part of any further study.

Tuberculosis.--Although the Seminoles of Florida have to this

time remained apparently free from rampant tuberculosis, they do exhibit

a great number of respiratory troubles, gastroenteritis, diarrhea and

dysentery among children. These conditions are named as possible har-

bingers of tuberculosis by Treon, after Holder (1892: 329), writing of

his experiences among the Crow Creek Agency in Dakota:

Consumption in these people appears in adults to follow an acute
attack of bronchitis or catarrhal pneumonia; while usually the
first symptom to which your attention is called in the child is
a looseness of the bowels, amounting at times to dysentery.

Conclusion

Comparison of certain conditions among recent Seminoles with

certain conditions of other Amerindians during and just after the

"frontier" acculturation of the past century, indicates that the

Seminole of Florida may present a delayed, but gaining acculturation

(as in a geometric progression), which other Amerindian peoples under-

went in the face of the last century's pioneer push.

Through the examination of the Seminole's way of life and his

surrounding physical and cultural environment, we have gained insight

into the effect of some of tne possible factors in the Seminole health

situation. Acculturation and environment are prime factors.

Although the effect of any ethnic immunity might be shown as

underlying factors in some of the problems indicated in this study, only

three cases were found in rhich direct explanation of a situation or

condition through ethnic consideration is indicated. These are the

discussions of trachoma (page 72), of cancer (page 69), and of

tuberculosis (page 70).

The forces of acculturation, thence the rigors of transition,

are indicated as the prime factors in describing he health of the

Seminole Indians of Florida.

It will take time to tell whether the continuing acculturation

of the Seminole will allow him to change appropriately with his

surroundings and thereby survive as a group. According to this study,'

the Florida Seminole is demonstrating grorring susceptibility to the ills

about him. It is possible that the appearance among the Seminoles of

diseases and conditions common to, and to the extent of, those concom-

itant to what we call modern civilization may indicate assimilation of

the Seminole into the context of his surroundings. This assimilation,

medically, is supported by the findings of cultural assimilation in

Chapter I, which underlie or give occasion to this medical assimilation.

Therefore, a general assimilation-indicated by the medical findings--

can be claimed.. At any rate, the annual population figures for the

period covered by this study have tended to increase.

Anon. 18h

Boyd, A. F.

Capron, L.

Gory, C. B.

Fairlie,

Freeman,

Friedman,

Greenlee,

1i.

E.

N

R

Hamlin, H.

Harrison, B

Holder, A.

BIBLIOGRAPHY

.0 Muskogees and Seminoles. The Monthly Magazine of
Religion and Literature 1: 137-147.